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Computed tomography and cross-sectional anatomy of the thorax in

clinically normal dogs

Article  in  American Journal of Veterinary Research · April 2005

DOI: 10.2460/ajvr.2005.66.512 · Source: PubMed

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Computed tomography and cross-sectional

anatomy of the thorax in clinically normal dogs
Lieve M. De Rycke, DVM; Ingrid M. Gielen, DVM, MSc; Paul J. Simoens, DVM, PhD;
Henri van Bree, DVM, PhD;

Objective—To provide a detailed anatomic descrip- plays a key role in the diagnosis and evaluation of var-
tion of the thorax in clinically normal dogs by means ious thoracic syndromes and diseases such as pneu-
of computed tomography. mothorax; pleural and pericardial effusion; collapse of
Animals—4 clinically normal adult German Shepherd a lung lobe; congenital anomalies; pulmonary
Dogs weighing 28 to 37 kg. parenchymal and bronchial diseases; cysts; abscesses;
and primary or metastatic neoplasia of the lungs, pleu-
Procedure—Dogs were anesthetized and positioned
in ventral recumbency for computed tomographic ra, mediastinum, lymph nodes, and chest wall.1,5-23
(CT) examination of the thorax. A CT image from the Furthermore, computed tomography is a useful preop-
thoracic inlet to the diaphragm was made by use of a erative technique, a precise staging tool, and improves
third-generation scanner with a slice thickness of 5 the use of biopsies by allowing detection of lesions not
mm. Individual images were reviewed by use of soft identifiable by fluoroscopy and determination of the
tissue (window width, 250 Hounsfield units; window location of high-risk masses that are close to cardio-
level, 35 Hounsfield units) and lung (window width, vascular structures.24,25,a
1,000 Hounsfield units; window level, –690 The use of computed tomography in diagnosing
Hounsfield units) settings. One dog, weighing 28 kg, thoracic diseases in veterinary medicine is in full explo-
was euthanatized, bound on a wooden frame in the ration,4,26-35 and an increasing number of published clin-
same position as used for CT examination, and frozen
at –14oC until solid. By use of an electric band saw, ical reports3,36-40 are found involving thoracic computed
the frozen thorax was sectioned at 10-mm-thick inter- tomography. Accurate interpretation of CT images of
vals. Slab sections were immediately cleaned, pho- the thorax requires a thorough knowledge of cross-sec-
tographed, and compared with corresponding CT tional anatomy of that region. A few papers41,42 on CT
images. anatomy of the thorax of clinically normal animals are
Results—Anatomic sections were studied, and iden- available. Authors of 1 paper41 described CT and cross-
tified anatomic structures were matched with struc- sectional anatomy of the thorax of clinically normal
tures on corresponding CT images. Except for some cats, and authors42 of another paper reported CT anato-
blood vessels and details of the heart, most of the my of the thorax of Nubian goats. The purpose of the
bony and soft tissue structures of the thorax dis- study reported here was to identify structures that are
cerned on anatomic slices could be found on matched visible on CT images of the canine thorax by means of
CT images. a detailed color atlas consisting of a series of labeled
Conclusions and Clinical Relevance—Because CT anatomic photographs. Although some publications2,43-46
images provide detailed information on most struc- on cross-sectional CT anatomy of the canine thorax
tures of the canine thorax, results of our study could exist, in the present study we combined the study of CT
be used as a guide for evaluation of CT images of the and gross anatomic sections, which provides more
thorax of dogs with thoracic diseases. (Am J Vet Res detailed and additional information.
2005;66:512–524)
Materials and Methods

D uring recent years, computed tomography of the

thorax has become established as an important
radiologic procedure.1 Computed tomographic (CT)
Animals—Four clinically normal adult German
Shepherd Dogs weighing 28 to 37 kg were used for this study.
Before the onset of CT examination, a clinical and radio-
graphic examination of the thorax of each dog was per-
displays of the lungs, mediastinum, pleural cavity, and formed, which included obtaining right and left lateral radio-
chest wall in a transverse plane provide unique diag- graphic views of the thorax.
nostic information that is unobtainable with conven-
tional radiographic techniques.1 Compared with con- Computed tomography—Dogs were sedated by use of
ventional radiography, computed tomography allows medetomidine hydrochlorideb (40 to 50 µg/kg of body
better distinction among specific tissue densities in the weight, IM) and anesthetized with thiopental sodiumc
(8 mg/kg, IV). After intubation, anesthesia was maintained
thorax and detection of subtle changes in organ size, with 1.5% to 2% halothane.d Intermittent positive-pressure
shape, margin contour, and position.2-4 ventilation was applied to the lungs to decrease motion arti-
In human medicine, use of computed tomography facts caused by irregular or fast respiration of the dogs.
Respiratory rate was set at 6 breaths/min.
Received December 31, 2003. Dogs were positioned in ventral recumbency on the
Accepted May 14, 2004. scanning table with forelimbs in extension. A lateral survey
From the Departments of Medical Imaging (De Rycke, Gielen, van view was made by use of a third-generation CT scanner.e
Bree) and Morphology (Simoens), Faculty of Veterinary Medicine, Transverse 5-mm-thick contiguous CT images of the thorax
Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium. from the thoracic inlet to diaphragm were obtained. Settings
Address correspondence to Dr. De Rycke. for the CT image technique were 120 kV and 100 mA. Hard

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copies were printedf on x-ray film by use of a soft tissue set- Tracheobronchial lymph nodes could be observed ven-
ting (window width, 250 Hounsfield units; window level, 35 tral to the tracheal bifurcation.
Hounsfield units) and a lung setting (window width, 1,000 Various parts of the thoracic wall including the
Hounsfield units; window level, −690 Hounsfield units). sternum, ribs with the intercostal muscles, and tho-
Comparison of CT and anatomic images—At the end racic vertebrae enclosing the spinal cord were clearly
of CT examination, 1 dog weighing 28 kg was euthanatized visible. Other identifiable structures were the scapulae,
for reasons unrelated to thoracic disease. For euthanasia, a nuchal ligament, and muscles of the thorax and proxi-
combinationg of embutramide, mebenzoniumiodide, and mal part of the forelimbs. In caudal sections, the liver
tetracaïne (0.3 mL/kg of body weight) was injected IV during with portal and hepatic blood vessels, gallbladder,
anesthesia. After euthanasia, the dog was bound on a wood- stomach, descending duodenum, and diaphragm could
en frame in the same position used for scanning and frozen be discerned.
at –14oC until solid. The frozen cadaver was placed on the
movable table of an electric band saw,h and serial transverse
In the 4 dogs examined, most of the previously
sections were cut approximately 10 mm apart, beginning at mentioned structures of the thorax could be identi-
the thoracic inlet and ending at the diaphragm. Slices were fied on CT images at the soft tissue setting. The
numbered and gently cleansed of debris with cold tap water heart silhouette could be observed, but cardiac
and light brushing. They were immersed in water, and the chambers, valves, and interventricular septum were
cranial surface of each section was photographed immediate- not visible.
ly (ie, before thawing). Photographs were studied, and iden- In any dog, it was impossible to distinguish the
tifiable anatomic structures were labeled with the aid of texts nuchal ligament or the left coronary artery, intercostal
on canine anatomy.47,48 For each anatomic slice, a corre- veins, vertebral vessels, lymph nodes, lobar bronchi,
sponding CT image was chosen on the basis of similar and various lobes of the lungs. In the cranial medi-
appearance. Identified structures were subsequently located
on CT images. Nomenclature used for designating all struc- astinum, the left and right axillary arteries and right
tures was in accordance with official anatomic terminology.49 costocervical trunk and vein could not be discerned.
From this collection, 24 representative matched pairs of Furthermore, portal and hepatic vessels, diaphragm,
images extending from the level of the sternal manubrium to and descending duodenum were not visible in the most
the most caudal part of the lungs were selected. caudal CT images of the 4 dogs. The left costocervical
trunk and contours of the gallbladder could be dis-
Results cerned in 2 of the 4 dogs. The ascending aorta, left cos-
The 24 selected levels, at which anatomic sections tocervical vein, left and right axillary vein, main
and their corresponding CT images were made, are bronchus of the accessory lobe of the right lung, and
indicated on a lateral survey view of the thorax of a left and right pulmonary veins could be identified in 3
German Shepherd (Figure 1). Identifiable anatomic of the 4 dogs by comparing their position on the cor-
structures are labeled on cadaver sections and corre- responding anatomic images. In all 4 dogs, most parts
sponding CT images (Figure 2). of the stomach could be seen.
On anatomic sections, various structures of the On CT images obtained at the lung setting, only
canine thorax could be identified. Respiratory tract various structures of the respiratory tract and some
structures including the trachea, tracheal bifurcation large vessels were distinct in all dogs. The tracheo-
(carina), principal bronchi, lobar bronchi, and various bronchial tree including the trachea, tracheal bifurca-
lobes of the left and right lungs were clearly visible. tion, principal bronchi, lobar bronchi, and various
Large vessels such as left and right external jugu- lobes of the left and right lung could easily be dis-
lar veins, brachiocephalic veins, common carotid cerned. In 1 dog, however, the main bronchus of the
arteries, subclavian and axillary arteries and veins, accessory lobe of the right lung could not be discerned.
costocervical trunks and veins, and the cranial vena Large intrathoracic vessels such as the descending
cava could readily be seen in the cranial medi- aorta, caudal vena cava, and major pulmonary arteries
astinum. Identification of these vessels could be
ascertained by comparing cross-sectional images on
successive levels. Other intrathoracic vascular struc-
tures including the thick-walled aortic arch, ascend-
ing and descending aorta, pulmonary arteries and
veins (located ventral to corresponding principal
bronchi), left coronary artery, internal thoracic arter-
ies and veins ventral to the transversus thoracis mus-
cle, right azygos vein (located dorsal to the esopha-
gus), intercostal veins, vertebral arteries and veins
within the transverse canal, and the prominent caudal
vena cava were observed.
Intrathoracic structures such as the heart with its
chambers and valves, esophagus, longus colli muscle,
and transverse thoracic muscle could easily be distin-
guished. Sternal lymph nodes were identified ventral to
the transversus thoracis muscle and dorsal to the
Figure 1—Lateral computed tomographic (CT) survey pilot
manubrium of the sternum. Cranial mediastinal lymph image of the thorax of a clinically normal dog indicating the lev-
nodes were discerned lateral to the cranial vena cava. els (A through X) at which the CT images were obtained.

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Figure 2—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2 continued—See page 522 for legend.

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Figure 2—Transverse anatomic section (left), CT soft tissue window image (middle), and CT lung window image (right) of the thorax
of a clinically normal dog. Images were obtained at sections A through X as illustrated in Figure 1.

L = Left. 66 = External oblique abdominal muscle.

R = Right. 67 = Pectoralis muscle (deep portion).
1 = Aortic arch. 68 = Pectoralis muscle (superficial portion).
2 = Aortic valve. 69 = Pleural cavity.
3 = Ascending aorta. 70 = Portal vein.
4 = Brachiocephalic trunk. 71 = Pulmonary trunk.
5 = Bronchus of the accessory lobe of the right lung. 72 = Quadrate lumbar muscle.
6 = Bronchus of the caudal lobe of the left lung. 73 = Straight abdominal muscle.
7 = Bronchus of the cranial lobe of the left lung. 73'= Straight thoracic muscle.
8 = Bronchus of the caudal lobe of the right lung. 74 = Rhomboid muscle (cervical portion).
9 = Bronchus of the cranial lobe of the right lung. 75 = Rhomboid muscle (thoracic portion).
10 = Bronchus of the middle lobe of the right lung. 76 = Rib.
11 = Cardiac sphincter. 77 = Right atrioventricular (tricuspidal) valve of the heart.
12 = Caudal vena cava. 78 = Right atrium of the heart.
13 = Cranial vena cava. 79 = Right auricle of the heart.
13’= Cranial mediastinal lymph node. 80 = Right axillary artery.
14 = Cutaneous trunci muscle. 81 = Right axillary vein.
15 = Deltoid muscle. 82 = Right azygos vein.
16 = Descending aorta. 83 = Right brachiocephalic vein.
17 = Descending duodenum. 84 = Right common carotid artery.
18 = Diaphragm (18' = left crus; 18'' = right crus). 85 = Right costocervical trunk.
19 = Eighth thoracic vertebra. 86 = Right costocervical vein.
20 = Eleventh thoracic vertebra. 87 = Right external jugular vein.
21 = Esophagus. 88 = Right internal thoracic artery.
22 = Fifth thoracic vertebra. 89 = Right internal thoracic vein.
23 = First thoracic vertebra. 90 = Right lung, accessory lobe.
24 = Fourth thoracic vertebra. 91 = Right lung, caudal lobe.
25 = Gallbladder. 92 = Right lung, cranial lobe.
25’= Bile duct. 93 = Right lung, middle lobe.
26 = Hepatic artery. 94 = Right principal bronchus.
27 = Hepatic vein. 95 = Right pulmonary artery.
28 = Iliocostal muscle (lumbar portion). 96 = Right pulmonary vein.
29 = Iliocostal muscle (thoracic portion). 97 = Right subclavian artery.
30 = Infraspinatous muscle. 98 = Right subclavian vein.
31 = Intercostal vein. 99 = Right ventricle of the heart.
32 = External intercostal muscle. 100 = Scalene muscle (dorsal part).
33 = Internal intercostal muscle. 101 = Scapula.
34 = Interventricular septum of the heart. 102 = Second thoracic vertebra.
35 = Latissimus dorsi muscle. 103 = Semispinal muscle of the head (biventer muscle).
36 = Left atrioventricular (mitral) valve of the heart. 104 = Semispinal muscle of the head (complexus muscle).
37 = Left atrium of the heart. 105 = Dorsal serrate muscle.
38 = Left auricle of the heart. 106 = Ventral serrate muscle.
39 = Left axillary artery. 107 = Seventh cervical vertebra.
40 = Left axillary vein. 108 = Seventh thoracic vertebra.
41 = Left brachiocephalic vein. 109 = Sixth cervical vertebra.
42 = Left common carotid artery. 110 = Sixth thoracic vertebra.
43 = Left coronary vessels. 111 = Spinal cord.
44 = Left costocervical trunk. 112 = Spinal muscle (cervical portion).
45 = Left costocervical vein. 113 = Spinal muscle (thoracic portion).
46 = Left external jugular vein. 114 = Splenius muscle.
47 = Left internal thoracic artery. 115 = Sternothyroid and sternohyoid muscle.
48 = Left internal thoracic vein. 116 = Sternum.
49 = Left lung, caudal lobe. 116'= Sternal lymph node.
50 = Left lung, cranial lobe. 117 = Stomach (117'= Fundus; 117'' = Corpus; 117'''= Pylorus).
51 = Left principal bronchus. 118 = Subscapular muscle.
52 = Left pulmonary artery. 119 = Supraspinatous muscle.
53 = Left pulmonary vein. 120 = Tenth thoracic vertebra.
54 = Left subclavian artery. 121 = Major teres muscle.
55 = Left subclavian vein. 122 = Third thoracic vertebra.
56 = Left ventricle of the heart. 123 = Trachea.
57 = Levator muscle of rib. 124 = Tracheal bifurcation.
58 = Liver. 124'= Tracheobronchial lymph node.
59 = Longissimus muscle (cervical portion). 125 = Transverse thoracic muscle.
60 = Longissimus muscle (thoracic and lumbar portion). 126 = Trapezius muscle (cervical portion).
61 = Long muscle of the neck. 127 = Trapezius muscle (thoracic portion).
62 = Manubrium of sternum. 128 = Triceps muscle of the forearm (long head).
63 = Multifidus muscle (thoracic portion). 129 = Twelfth thoracic vertebra.
64 = Ninth thoracic vertebra. 130 = Vertebral artery.
65 = Nuchal ligament. 131 = Vertebral vein.
65' = Supraspinal ligament.
and veins could be identified in all instances. Of the Discussion
heart and liver, only contours were visible. The pres- Results of our study indicate that the use of
ence of air in the esophagus and in cardia and fundus anatomic sections is helpful for identifying a large
of the stomach allowed the position of these organs to number of thoracic structures that are visible on CT
be determined on CT images. However, it was impossi- images of the canine thorax. Only nerves and small
ble to see the cardiac sphincter and all parts of the vessels could not be discerned. Anatomic images made
stomach in any dog. in our study matched closely with corresponding CT

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images, except for the more caudal position of the use in animals as a diagnostic and preoperative tool for
scapulae on CT images. This indicates that the fore- detection of thoracic diseases and as a guide for per-
limbs were less extended during CT examination than forming thoracic biopsies will undoubtedly evolve.1
during the freezing process. Results of our study indicate that CT images provide
Thoracic CT images were evaluated by use of a detailed information on most structures of the canine
lung and a soft tissue (mediastinal) setting. Various thorax. Therefore, our description of CT anatomy of
structures of the respiratory tract were most distinct on the canine thorax could be used for evaluation of CT
the lung window. Still, for detection of pathologic images of dogs with thoracic disease.
processes, the lungs should be evaluated with lung and
soft tissue windows to avoid missing lesions excluded a. Tidwell A, Johnson K. Applications of CT guided biopsy in
by window settings.32 For a complete examination of small animals (abstr). Vet Radiol Ultrasound 1998;39:238.
b. Domitor, Orion Corp, Espoo, Finland.
the lungs, it is recommended to scan the patient in var- c. Pentothal, Abbott Laboratories, North Chicago, Ill.
ious positions, depending on the area of interest, d. Fluothane, Zeneca, Wilmington, Del.
because atelectasis and gravitational pulmonary-flow e. CT-scanner Pace Plus, GE Medical Systems, Milwaukee, Wis.
f. X-ray film, Fuji Photo Film Co, Tokyo, Japan.
differences may alter the density of the dependent g. T-61, Hoechst Roussel Vet GmbH, Unterschleibheim, Germany.
lung. Assisted suspended inspiration may also be need- h. Electric band saw, Eureka, Savioli Lelio Snc, Coriano, Italy.
ed to better assess overall lung density.32
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